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Case number:	112
Age:	69
Clinical presentation:	Postmenopausal woman with average risk of developing breast cancer presented with acute onset of itching and redness of the left nipple. Examination revealed redness and inflammation around the nipple with underlying irregular nodularity.

Mammography:

Breast composition:	ACR category b (there are scattered areas of fibroglandular density)
Mammography features:
‣ Location of the lesion:	Left breast
‣ Mass:
• Number:	0
• Size:	None
• Shape:	None
• Margins:	None
• Density:	None
‣ Calcifications:
• Typically benign:	None
• Suspicious:	None
• Distribution:	None
‣ Architectural distortion:	None
‣ Asymmetry:	None
‣ Intramammary node:	None
‣ Skin lesion:	None
‣ Solitary dilated duct:	None
‣ Associated features:	Skin thickening, axillary reactive lymphadenopathy

Ultrasound:

Ultrasound features: Left breast, central portion of the breast
‣ Mass
• Location:	Left breast, central portion of the breast
• Number:	0
• Size:	None
• Shape:	None
• Orientation:	None
• Margins:	None
• Echo pattern:	None
• Posterior features:	No posterior features
‣ Calcifications:	None
‣ Associated features:	Skin thickening and axillary reactive lymphadenopathy
‣ Special cases:	None

BI-RADS:

BI-RADS Category: 2 (benign)

Case summary:

Postmenopausal woman presented with acute onset of itching and redness of left nipple. Diagnosed as infection in the left breast, BI-RADS 2 on imaging.

Learning points:

Breast inflammatory changes are seen in the non-puerperal stage in women with systemic illness such as diabetes mellitus. They need medical management. Triple assessment and imaging rules out the possibility of underlying breast malignancy with features of inflammatory carcinoma.